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2018 Mission St Santa Cruz CA 95060-5218 | |
| (831) 465-7761 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 2018 Mission St, Santa Cruz, California |
| Authorized Official Name and Position | Theresa M Hylen (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 9168512559 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3000 Q St Sacramento CA 95816-7058 Ph: (916) 733-5701 | 2018 Mission St Santa Cruz CA 95060-5218 Ph: (831) 465-7761 |
| NPI Number | 1649446352 |
|---|---|
| Provider Enumeration Date | 05/02/2008 |
| Last Update Date | 11/18/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649446352 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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